Small-diameter arterial substitutes are urgently needed as incidences of atherosclerotic arterial disease, especially coronary artery disease, rises with an aging population and increasing obesity. Autologous vessels are commonly used for bypass surgery to replace diseased and damaged arteries with an inner diameter less than 6 mm. However, autografts have several limitations including low availability, donor site morbidity, compliance mismatch, and late intimal hyperplasia, which often cause graft failure. Tissue engineering is an alternative to autografts with the potential to develop small-diameter arterial constructs that are nonthrombogenic, strong, and compliant. Yet, neither synthetic nor tissue-engineered grafts have yet to show clinical effectiveness in arteries smaller than 6 mm. Therefore, a need exists for small-diameter arterial substitutes that are nonthrombogenic, strong and compliant, but are effective in arteries less than 6 mm.